So a lady rang the other night asking for a blood pressure check..
Now I’m going to be completely frank, I think blood pressure checks are a total waste of my time. And the patient’s time. Vien you ask, why the strong stance? Because blood pressure is one in a million potential marker for health. If you can glean anything from a single blood pressure reading I’ll kneel to you. But on it’s own it means nothing. In the same person there can be totally different readings minute to minute let alone morning to evening – we have a body clock that’s diurnal, awake during daylight, asleep at night. The heart pumps accordingly.
But I know there’s going to be an interesting story to people’s health issues so I listen on…the patient has been diagnosed with low blood pressure a few months back. But today she’s suffering from tingling and numbness in the hands and feet. Worst at night – so much so that it wakes her. Could it be that she’s tucked the hands under her own body weight causing loss of circulation? That’s quite plausible. But not if it’s been happening for the last week on consecutive nights.
Whenever I deal with patients I look at them in the whole. The context matters too. We’ve been in COVID lockdown for three months (Jun-Aug) now with no end in sight. This naturally changes people’s routines. She admitted to a change in diet over the last month with more sweets, biscuits, snacking. Half a glass of coffee in the morning. A frappè in the afternoon. These all suggest sub-optimal nutrition – I suspect low magnesium. Sugar and caffeine leach out magnesium causing muscle aches, spasms, and numbness and tingling. She get’s immediate headaches upon her first coffee which is strongly indicative of her sub-optimal state where the slightest insult triggers her.
Good news: ultimately, her presenting concerns had nothing in relation to low-blood pressure.
Better news: while the problem is layered and co-morbid (inter-related), the solution is often simple, as Dr Phil would say. In this case, the solution is less caffeine, more water, cut out sugar, and up natural sources of magnesium: nuts, greens, meats.